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. 2007 Oct;64(10):1489-95.
doi: 10.1001/archneur.64.10.1489.

Three-dimensional gray matter atrophy mapping in mild cognitive impairment and mild Alzheimer disease

Liana G Apostolova  1 , Calen A Steiner, Gohar G Akopyan, Rebecca A Dutton, Kiralee M Hayashi, Arthur W Toga, Jeffrey L Cummings, Paul M Thompson
Affiliations

Three-dimensional gray matter atrophy mapping in mild cognitive impairment and mild Alzheimer disease

Liana G Apostolova et al. Arch Neurol. 2007 Oct.

Abstract

Background: Alzheimer disease (AD) is the most common form of dementia worldwide. Mild cognitive impairment (MCI) is the recent terminology for patients with cognitive deficiencies in the absence of functional decline. Most patients with MCI harbor the pathologic changes of AD and demonstrate transition to dementia at a rate of 10% to 15% per year. Patients with AD and MCI experience progressive brain atrophy.

Objective: To analyze the structural magnetic resonance imaging data for 24 patients with amnestic MCI and 25 patients with mild AD using an advanced 3-dimensional cortical mapping technique.

Design: Cross-sectional cohort design. Patients/

Methods: We analyzed the structural magnetic resonance imaging data of 24 amnestic MCI (mean MMSE, 28.1; SD, 1.7) and 25 mild AD patients (all MMSE scores, >18; mean MMSE, 23.7; SD, 2.9) using an advanced 3-dimensional cortical mapping technique.

Results: We observed significantly greater cortical atrophy in patients with mild AD. The entorhinal cortex, right more than left lateral temporal cortex, right parietal cortex, and bilateral precuneus showed 15% more atrophy and the remainder of the cortex primarily exhibited 10% to 15% more atrophy in patients with mild AD than in patients with amnestic MCI.

Conclusion: There are striking cortical differences between mild AD and the immediately preceding cognitive state of amnestic MCI. Cortical areas affected earlier in the disease process are more severely affected than those that are affected late. Our method may prove to be a reliable in vivo disease-tracking technique that can also be used for evaluating disease-modifying therapies in the future.

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Figures

Figure 1
Figure 1
Schema of the cortical pattern matching method. ICBM indicates International Consortium for Brain Mapping.
Figure 2
Figure 2
Statistical (top) and correlation maps (bottom) of the cortical gray matter differences between patients with amnestic mild cognitive impairment (MCI) and mild Alzheimer disease (AD). The significance maps were created using 3-dimensional surface-based linear regression analysis and show regions in which gray matter atrophy is significantly associated with diagnosis of mild AD (as opposed to MCI). The correlation maps show the regional strength of the association between gray matter atrophy and clinical diagnosis, with positive correlations showing an association with a diagnosis of AD.
Figure 3
Figure 3
Ratio maps show the areas of the cortex with greater gray matter atrophy (percentage) in Alzheimer disease compared with amnestic mild cognitive impairment.
Figure 4
Figure 4
Left-right asymmetry maps in mild cognitive impairment (MCI) and Alzheimer disease (AD). The right hemisphere shows more gray matter atrophy in both groups. The effect is most pronounced in the lateral temporal and inferior frontal cortices.
See this image and copyright information in PMC

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